Association between one's own consumption and harm from others' drinking: Does education play a role?

Introduction: We examined (a) whether risky drinking behaviour is related to experienced harm from others' drinking (EHFOD) and (b) whether any found relationship is modified by educational level, such that those of lower socio-economic status (SES) experience more harm even when adjusted for drinking behaviour. Method: Data from the Danish national alcohol and drug survey of 2011 (N=5133) were linked with registry data from Statistics Denmark. Eight EHFOD indicators were grouped into nuisance, harassment or harm/damage categories. Indicators for mean alcohol consumption, Alcohol Use Disorder Identification Test (AUDIT) and binge drinking were examined in relation to respondents' EHFOD with multiple logistic regression, stratified by sex and education (proxy for SES). Results: One-year prevalence of EHFOD was 50%. We found a positive and significant relationship between own alcohol consumption and EHFOD categories of harassment as well as harm/damage. Effect modification of education was significant for harassment. Among men, odds ratios for the association between risky drinking behaviour and harassment were 5.50 (95% confidence interval (CI) 3.49-8.65) in the low educational group versus 1.42 (95% CI 0.98-2.07) in the high educational group. Conclusions: Our study confirmed an overall positive relationship between EHFOD and drinking behaviour, but it varied by type of EHFOD. Furthermore, education modified this effect for harassment, suggesting evidence of the alcohol harm paradox with respect to EHFOD. More research is necessary to understand better how drinking patterns diverge between low and high educational groups as well as sex, and how this differentially affects risk for alcohol-related harms, including EHFOD.

[School-based alcohol prevention with virtual reality]. / Schulische Alkoholprävention mittels Virtual Reality.

Risky alcohol consumption among adolescents continues to be of high public health relevance in Germany. Therefore, preventive measures should promote the skills of adolescents to deal with alcohol and peer pressure. Interactive and gender-sensitive primary prevention programs in schools have a great potential to reach the target group and to increase the effectiveness of interventions. Digital tools such as virtual simulations may help with this process.Virtual reality (VR) enables the experience of risk situations in a safe environment. Internationally, there are currently two VR alcohol prevention programs for adolescents. Their co-creation with the target group was a core element, and comprehensive research on the usability and subjective effectiveness has already been published. Conventional effectiveness evaluations such as randomized controlled trials, however, have limitations with interactive formats. Alternative and complementary evaluation approaches are needed in the future. Furthermore, the potential of tailoring VR to recipients has to be examined. In this context, a gender-sensitive design is both an opportunity and a challenge.Further research is needed to study possibilities to use VR in alcohol prevention in adolescents in Germany.

Negative Consequences of Substance Use in European University Students: Results from Project SNIPE.

BACKGROUND: University students are a risk group for heavy substance use and the experience of various potentially severe negative substance use consequences which may impact on their health, social, and academic functioning. Whilst the experience of negative consequences of substance use is well understood in North American student samples, there is little data on these experiences in European students. In order to develop effective harm prevention and reduction interventions for students' substance use, there needs to be an understanding of the types of consequences experienced in European student samples. OBJECTIVES: The aim of the study was to investigate the prevalence and predictors of the experience of negative substance use-related consequences amongst university students in 7 European countries. METHODS: University students (n = 4,482) in Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey, and the UK completed an online survey of their substance use behaviours and the experience of associated negative consequences. RESULTS: European students reported that experiencing a hangover or illness, missing class, being short of money, and experiencing memory loss were the most commonly experienced negative consequences of substance use. Not living with other students and using alcohol, cannabis, sedatives, and cocaine were also associated with higher odds of experiencing these negative consequences. CONCLUSIONS: In contrast to North American data, European university students tended to experience consequences that are associated with lower level health risks rather than more severe consequences (e.g., drink-driving and physical injury). Harm prevention and reduction interventions for students should be targeted towards those consequences that are most salient to the target group to ensure feedback is relevant and potentially more effective in changing students' substance use behaviours.

Area-level relative deprivation and alcohol use in Denmark: Is there a relationship?

AIMS: Greater area-level relative deprivation has been related to poorer health behaviours, but studies specifically on alcohol use and abuse have been equivocal. The main purpose of the present study was to investigate how area-level relative deprivation in Denmark relates to alcohol use and misuse in the country. METHODS: As individual-level data, we used the national alcohol and drug survey of 2011 ( n= 5133). Data were procured from Statistics Denmark to construct an index of relative deprivation at the parish level ( n=2119). The deprivation index has two components, which were divided into quintiles. Multilevel linear and logistic regressions analysed the influence of area deprivation on mean alcohol use and hazardous drinking, as measured by the Alcohol Use Disorder Identification Test. RESULTS: Men who lived in parishes designated as 'very deprived' on the socioeconomic component were more likely to consume less alcohol; women who lived in parishes designated as 'deprived' on the housing component were less likely to drink hazardously. But at the individual level, education was positively related to mean alcohol consumption, and higher individual income was positively related to mean consumption for women. Higher-educated men were more likely to drink hazardously. CONCLUSIONS: Area-level measures of relative deprivation were not strongly related to alcohol use, yet in the same models individual-level socioeconomic variables had a more noticeable influence. This suggests that in a stronger welfare state, the impact of area-level relative deprivation may not be as great. Further work is needed to develop more sensitive measures of relative deprivation.

European University Students' Experiences and Attitudes toward Campus Alcohol Policy: A Qualitative Study.

BACKGROUND: Many studies indicate that a substantial part of the student population drinks excessively, yet most European universities do not have an alcohol policy. In the absence of an alcohol guideline at universities and the easy access to alcohol sold at the student cafeteria, for instance, this has the potential to place students at risk of overconsumption, which has adverse health consequences. OBJECTIVES: Therefore, our study objectives were to explore and compare university students' experiences and attitudes toward alcohol policy on their campus using a qualitative approach. METHODS: 29 focus group discussions (FGDs) were conducted among students from universities in five European countries: Belgium (4 FGDs), Denmark (6 FGDs), France (5 FGDs), Hungary (6 FGDs), and the Slovak Republic (8 FGDs), with a total number of 189 participants. RESULTS: Across the five European countries, students recognized that alcohol was a big problem on their campuses yet they knew very little, if any, about the rules concerning alcohol on their campus. CONCLUSIONS: Students will not support an on campus alcohol restriction and a policy should therefore focus on prevention initiatives.

Is economic dependence on the husband a risk factor for intimate partner violence against female factory workers in Nepal?

BACKGROUND: Violence related injury is a serious public health issue all over the world. This study aims to assess the association between several socio-economic factors and intimate partner violence (IPV) in Nepal. METHODS: A cross-sectional study was conducted among 236 women working in carpet and garment factories in Kathmandu, Nepal. Interviews were conducted to collect quantitative data on three forms of IPV, namely physical violence, psychological violence and sexual violence, as well as on a number of potentially associated factors. RESULTS: Twenty-two percent of women experienced sexual IPV, 28% physical IPV and 35% psychological IPV at least once in the last 12 months. The variables independently associated with at least one form of IPV were: age of the woman >29 years [OR = 4.23, p = 0.025 for physical IPV; OR = 6.94, p = 0.008 for sexual IPV; OR = 3.42, p = 0.043 for psychological IPV], alcohol consumption of the husband [OR = 9.97, p < 0.001 for physical IPV; OR = 3.76, p = 0.004 for sexual IPV; OR = 4.85, p < 0.001 for psychological IPV], education of the husband above primary level [OR = 0.43, p = 0.013 for physical IPV; OR = 0.51, p = 0.033 for psychological IPV], and economic dependency of the woman on the husband [OR = 3.04, p = 0.021 for physical IPV; OR = 2.97, p = 0.008 for psychological IPV]. CONCLUSIONS: This study identified various factors associated with IPV and showed that economic dependence of wives on their husband was among the most important ones. Thus, for the prevention of IPV against women, long term strategies aiming at livelihood and economic empowerment as well as independence of women would be suggested.

Are perceptions of social norms regarding peer alcohol and other drug use associated with personal use in Danish adolescents?

AIMS: This study aims to describe norm perceptions among Danish pupils aged 13-17 years related to the prevalence of personal lifetime use of alcohol and other drugs (AODs). Further we examined if norm perceptions were associated with personal lifetime AOD use. METHOD: The data were collected as baseline data in the trial The GOOD Life. A total of 2601 pupils from 42 public schools in the Region of Southern Denmark completed an online questionnaire measuring personal lifetime AOD use and personal approval of use. Additionally the perceived frequency of AOD use and approval of use among peers of their own grade were measured. Lifetime AOD outcome variables were alcohol consumption (at least one drink, being drunk and had five or more drinks on one occasion), smoking, and cannabis use. RESULTS: Pupils' perceptions of peer approval were significantly higher than pupils' personal approval of AOD use among adolescents for all outcomes. With the exception of cannabis use the estimated AOD prevalence among peers (median) were higher than the actual prevalence of personal lifetime use. Multilevel logistic regression models showed a significantly increased risk of personal AOD use for pupils that overestimated their peers' AOD use and also for pupils that perceived peers to approve of AOD use. CONCLUSIONS: The findings highlight that pupils' exaggerated perceptions regarding their peers' use and approval of AOD use are related to personal experience with AODs.

Trends in Tobacco Smoking among Czech School-aged Children from 1994 to 2014.

OBJECTIVE: The aim of the article is to examine trends in tobacco consumption among the Czech school-age population. METHODS: For the analysis, data from the Czech Health Behaviour in School-aged Children project, conducted between 1994 and 2014 were used. Trends in tobacco smoking were determined separately for boys and girls, applying the binary logistic regression with survey period as an independent variable for the smoking status. RESULTS: The analysis showed that there have been significant changes in adolescent tobacco smoking for the recent 20 years. While the share of current school-aged smokers was continuously increasing since the mid-1990s, the trend reached its peak in the mid-2000s. CONCLUSION: In recent years, the prevalence of adolescent smokers has significantly declined in the Czech Republic. Despite this recent decline, adolescent smoking remains a major challenge for the national health policy.

The GOOD life: Study protocol for a social norms intervention to reduce alcohol and other drug use among Danish adolescents.

BACKGROUND: It is currently unknown if school-based social norms interventions are effective in preventing harmful alcohol consumption and other drug use among adolescents in Denmark. This paper describes the social norms-based programme The GOOD life and the design of a cluster-randomized controlled trial to test its effectiveness. METHODS/DESIGN: The intervention The GOOD life is composed of three social norms components representing three different communication channels, namely face-to-face communication (normative feedback session), print communication (posters) and interactive media (web application). The intervention period of 8 weeks is preceded and followed by data collection, with the follow-up taking place 3 months after baseline. Public schools in the Region of Southern Denmark with grades 8 and 9 are invited to participate in the study and participating schools are randomly allocated to either intervention or control schools. The aim is to recruit a total of 39 schools and a sample of 1.400 pupils for the trial. An online questionnaire is conducted to examine the use of alcohol, tobacco and marijuana as well as the perceived frequency of use among peers of their own grade, which is measured before and after the intervention. Baseline data is used to develop social norms messages which are included in the three intervention components. Primary outcomes are binge drinking (more than 5 units at one occasion) and perceived frequency of binge drinking among peers, while smoking, marijuana use and alcohol-related harm will be assessed as secondary outcomes. DISCUSSION: The GOOD life study will provide necessary insights on descriptive and injunctive norms regarding alcohol and other drug use among Danish adolescents. In addition, it will provide new knowledge and insight on the feasibility, implementation context and effectiveness of a newly developed social norms intervention in the Danish school context. TRIAL REGISTRATION: Date of registration: 17 February 2016 (retrospectively registered) at Current Controlled Trials with study ID ISRCTN27491960.

Explaining the gender difference in self-rated health among university students in Egypt.

In this study the authors assessed gender differences in the relationships between self-rated health (SRH) and demographic factors, physical health, health service use, infections, a variety of symptoms and health conditions, and wider well-being features. A self-administered questionnaire was administered to 3,271 students at Assiut University, Egypt during 2009-2010. Multiple logistic regression was used (with excellent/very good SRH as dependent variable) to assess the variables that might explain the gender difference in SRH. Females had more symptoms, infectious diseases/illness periods, substantially lower quality of life, and more burdens, although their health awareness and satisfaction with social support were higher than males. The unadjusted odds ratio (OR) suggested that females were less likely than males to rate their SRH as excellent/very good [OR 0.56, 95% confidence interval (CI) 0.47-0.68]. Adjusting only for relevant physical health and health service use variables, the OR for excellent/very good SRH for females increased, but nevertheless still remained significantly lower than that of males. With further adjustment for physical health, health service use, and also for wider well-being variables, the gender difference in SRH became no longer statistically significant. Poorer physical health indicators and a lower level of wider well-being features explained the lower SRH among female Egyptian university students. Health promotion and prevention programs should consider these factors in attempting to address gender health disparities.

How can we strengthen students' social relations in order to reduce school dropout? An intervention development study within four Danish vocational schools.

BACKGROUND: This article describes the rationale and contents of an intervention program aimed at strengthening students' social relations in order to reduce dropout from vocational schools in Denmark. Taking its theoretical cue from the concept of 'social participation', a qualitative study was performed to investigate the specific relationships between the social environment within the schools and the institutional structures in order to analyse reasons for school dropout and their relation to well-being, cigarette smoking and substance use. METHODS: The development study was based on ethnographic methods, including 22 qualitative interviews with students 17-19 years old and fieldwork with participant observations at four vocational schools over 40 days, including informal interviews and discussion meetings with managers, teachers, counselors and students. As part of the fieldwork, four additional qualitative interviews and four group interviews were conducted with students 16-25 years old. RESULTS: The qualitative data collection resulted in seven major themes to be addressed in the intervention: social relations, sole focus on professional skills, institutionalized individualization, importance of the introduction period, physical surroundings and schedules, tobacco and cannabis use and communication about drug use. The program addressing these themes incorporates suggestions that are meant to improve how teachers welcome new students, to enable greater integration of social and educational activities and to enhance the capacity of teachers and counselors to deal with drug use problems among students. CONCLUSION: The development of new intervention programs might benefit from adopting a theoretical and methodological perspective that enables a closer exploration of the everyday social practices in which interventions are embedded. Thus, we aimed to create a comprehensive intervention that worked through organizational changes in everyday school practices. Intervention programs must be planned in dialogue and collaboration with practitioners in the field to ensure the pertinence and usability of the program.

Shaping the Social: design of a settings-based intervention study to improve well-being and reduce smoking and dropout in Danish vocational schools.

BACKGROUND: The social environment at schools is an important setting to promote educational attainment, and health and well-being of young people. However, within upper secondary education there is a need for evidence-based school intervention programmes. The Shaping the Social intervention is a comprehensive programme integrating social and educational activities to promote student well-being and reduce smoking and dropout in upper secondary vocational education. The evaluation design is reported here. METHODS/DESIGN: The evaluation employed a non-randomised cluster controlled design, and schools were selected to either implement the intervention or continue with normal practice for comparison. In the baseline survey conducted 2011-2012, 2,329 students from four intervention schools and 3,371 students from six comparison schools answered a computer-based questionnaire during class, representing 73% and 81% of eligible students, and 22% of all technical/agricultural vocational schools in Denmark. Follow-up assessment was conducted 10 weeks after baseline and at the same time teachers of the intervention classes answered a questionnaire about implementation. School dropout rates will be tracked via national education registers through a 2-year follow-up period. DISCUSSION: Shaping the Social was designed to address that students at Danish vocational schools constitute a high risk population concerning health behaviour as well as school dropout by modifying the school environment, alongside developing appropriate evaluation strategies. To address difficulties in implementing settings-based interventions, as highlighted in prior research, the strategy was to involve intervention schools in the development of the intervention. Baseline differences will be included in the effectiveness analysis, so will the impact of likely mediators and moderators of the intervention. TRIALS REGISTRATION: ISRCTN57822968. Date of registration: 16/01/2013.

Condom use in the context of romantic relationships: A study among university students from 12 universities in four Central and Eastern European countries.

OBJECTIVE: To investigate the extent to which romantic relationship status influences condom use during vaginal, oral and anal sex among students from 12 universities in the Czech Republic, Hungary, Lithuania and Slovakia. METHODS: A pilot study of 880 students from the ongoing Student Life Cohort in Europe (SLiCE) study. Multiple logistic regression was conducted to establish the effect of romantic relationship status on condom use during vaginal, anal and oral sex in the previous 30 days, while adjusting for participants' age, gender, use of alcohol and other drugs prior to sex, condom-carrying practices and number of sexual partners. RESULTS: Of the total sample, 73.7% were currently engaged in a romantic relationship and their condom use during vaginal sex (p < 0.001), oral sex (p < 0.001) and anal sex (p = 0.003) was significantly associated with their romantic relationship status. Students who were not in a romantic relationship had the lowest odds of condom use. Use of alcohol or other drugs before sex was detrimental to condom use (odds ratio 0.5; p = 0.045) during vaginal sex. Condom use during vaginal and oral sex was lower among older students. CONCLUSION: The need to target university students with more pragmatic sexual health risk reduction interventions that accommodate the role of romantic relationships on behavioural choices is justified.

Student estimations of peer alcohol consumption: links between the Social Norms Approach and the Health Promoting University concept.

BACKGROUND: The Social Norms Approach, with its focus on positive behaviour and its consensus orientation, is a health promotion intervention of relevance to the context of a Health Promoting University. In particular, the approach could assist with addressing excessive alcohol consumption. AIM: This article aims to discuss the link between the Social Norms Approach and the Health Promoting University, and analyse estimations of peer alcohol consumption among European university students. METHODS: A total of 4392 students from universities in six European countries and Turkey were asked to report their own typical alcohol consumption per day and to estimate the same for their peers of same sex. Students were classified as accurate or inaccurate estimators of peer alcohol consumption. Socio-demographic factors and personal alcohol consumption were examined as predictors for an accurate estimation. RESULTS: 72% of male and 51% of female students were identified as having accurate estimations about the amount of alcoholic drinks consumed per day by their peers. Male students, older students, those studying year 3 and above, and Turkish and Danish students were more likely to accurately estimate their peers' alcohol consumption. Independent from these factors, students' accurate estimation of peers' drinking decreased significantly with increasing personal consumption. CONCLUSIONS: As accurate estimates of peer alcohol consumption appear to affect personal drinking behaviour positively, social norms interventions targeted at correcting possible misperceptions about peer alcohol use among students may be a useful health promotion tool in the context of a health promoting university.

Do importance of religious faith and healthy lifestyle modify the relationships between depressive symptoms and four indicators of alcohol consumption? A survey of students across seven universities in England, Wales, and Northern Ireland.

We examined the associations between depressive symptoms and four indicators of alcohol consumption (high frequency of drinking, frequency of heavy episodic drinking, problem drinking, and possible alcohol dependence). We also explored whether personal importance of religious faith as well as healthy lifestyle had any modifying roles in these relationships. During 2007-2008, 3,220 students at seven UK universities completed a questionnaire containing questions on CAGE, frequency alcohol use, heavy episodic drinking, modified Beck-Depression Inventory, physical activity and sleep, and importance of religious faith. Multivariate logistic regressions were performed separately for four alcohol consumption indicators, stratified by gender. Controlling for demographic variables, depressive symptoms were positively associated with problem drinking and possible alcohol dependence for both genders. Religiosity was negatively associated with frequency of drinking and heavy episodic drinking among both genders, while healthy lifestyle was not associated with any of the four measures of alcohol consumption among both genders. No evidence suggested that either religiosity or healthy lifestyle modified the relationships between depressive symptoms and any of the four measures of alcohol consumption. This study shows a link between hazardous drinking and mental ill health and suggests religiosity as a protective factor for high alcohol consumption. Promotion of students' mental and spiritual health could have a preventive role in hazardous drinking at universities.

Symptoms and health complaints and their association with perceived stress at university: survey of students at eleven faculties in Egypt.

AIMS: This study examined the relationships between perceived stress and a range of self reported symptoms and health complaints in a representative sample of students at one university in Egypt. METHODS: The data (3,271 students) was collected during the academic year 2009-2010 at eleven faculties at the university of Assiut city, Egypt. A self-administered questionnaire measured health complaints (22 symptoms) and Cohen's Perceived Stress Scale. Socio-demographic and lifestyle data were also collected. Factor analysis generated four groups of health complaints: psychological, circulatory/breathing, gastrointestinal, and pains/aches, and the internal consistency of each group of symptoms was computed using reliability analyses (Cronbach's alpha). Perceived stress was categorized into four levels based on quartiles. Multiple binomial or multinomial logistic regression analyses analysed the relationship between each of the four groups of symptoms and other students' general characteristics adjusted for the effect of all other groups of symptoms. RESULTS: The symptoms most often reported as having occurred sometimes/very often in the last 12 months were fatigue (85.3%), difficulties to concentrate (78.1%), headache (77.9%), and mood swings (74.5%), while nervousness/anxiety (63.2%) and sleep disorder (63.7%) affected many students. Multinominal logistic regression revealed a clear association and a linear trend between increasing level of stress and a higher frequency of psychological symptoms that remained significant after adjustment for other groups of symptoms. There were no associations between perceived stress and circulatory/breathing symptoms, gastrointestinal symptoms, or for pains/aches. Poor health was consistently associated with higher frequency of symptoms across all symptom groups except for gastrointestinal symptoms. Higher health awareness was associated with lower frequency of psychological and circulatory/breathing symptoms but not for the other two symptom groups. Better quality of life was associated with lower frequency of psychological and partly for circulatory/breathing symptoms, but not for the other two symptom groups. There were differences in levels of psychological symptoms and of perceived stress between faculties, where students of Physical Education showed the lowest risk profile regarding both psychological symptoms and perceived stress, while students of Veterinary Medicine showed the highest risk profile. Across all four symptom groups, females had higher ratings of complaints than males. CONCLUSIONS: The high prevalence of health complaints especially of psychological and pains/aches type of symptoms raise concern and calls for preventive actions at universities. Comprehensive programmes would be recommended that take the co-occurence of perceived stress and health complaints into account.

Physical activity and gender differences: correlates of compliance with recommended levels of five forms of physical activity among students at nine universities in Libya.

AIMS: This cross-sectional survey assessed and compared by gender the levels and correlates of achieving the international guidelines recommendations on five forms of physical activity (PA) (walking, moderate PA, vigorous PA, moderate or vigorous PA- MVPA, and muscle-strengthening PA). We examined the associations between achieving the international guidelines recommendations on five forms of PA and a variety of sociodemographic, health and academic performance variables. METHODS: Data was collected across nine Libyan universities (2008-2009, representative sample of 1,300 undergraduates). A self-administered questionnaire assessed frequency and duration of PA/week for each form of PA. Cut-offs for recommended guidelines were set according to the American Heart Association. RESULTS: About 43.7% of students achieved the guidelines for muscle strengthening PA, 20.7% for walking, 11.2% for vigorous PA, 28.5% for MVPA, and 4.8% for moderate PA (excluding walking). Binary logistic regression showed that except for walking, males were consistently associated with achieving the guidelines recommendations for all other forms of PA. Students with higher health awareness were more likely to achieve the guidelines for vigorous PA and muscle strengthening PA. Better academic performance was associated with higher levels of muscle strengthening PA. Students at institutions in the East of Libya were less likely to achieve the guidelines for walking, vigorous PA or muscle strengthening PA as compared to students from the North. Students from the West of Libya were also less likely to walk or to engage in moderate PA than their peers from the North. CONCLUSIONS: Overall, relatively low proportions of students achieved the recommended guidelines of PA. Female students were particularly at risk for low level of PA. Attention is required to national policies that promote active living, along with addressing the cultural, geographic and other barriers to engagement of young adult males and females in PA.

Body image concerns: levels, correlates and gender differences among students in the United Kingdom.

AIMS: This cross-sectional study aimed to determine the socio-demographic, lifestyle and well-being variables that are associated with body image concerns (BIC) and whether these associations differed between female and male students. METHODS: A cross-sectional survey; 3,706 undergraduate students (2,699 females, 765 males) from seven universities in the UK completed a self-administered questionnaire that assessed socio-demographic, lifestyle, well-being and BIC based on the Body Shape Questionnaire developed by Cooper et al. Multifactorial logistic regression analysis examined the odds ratios for the association between four increasing levels of BIC as the dependent variables (no BIC, mild BIC, moderate BIC and marked BIC) on the one hand, and the socio-demographic (gender, age, year at university), lifestyle (physical activity, nutrition) and mental well-being variables (quality of life, perceived stress, perceived health, depressive symptoms) on the other. RESULTS: More females (35%) than males (8%) reported being moderately or markedly concerned with their body image. For both genders, BIC was associated with a higher level of depressive symptoms and to variable extents, with nutrition and year at university. Females' BICs were exclusively associated with low perceived health, higher perceived stress, studies in general as a stressor, and low physical activity. In contrast, males' BIC were found to be exclusively associated with low quality of life and with older age. CONCLUSIONS: Health promoting strategies and activities should address the co-occurrence of depressive symptoms and BIC and should moreover pay attention to the gender-specific correlates of BIC for tailoring evidence based interventions for females and for males.

Depressive Symptoms Among Higher Education Students in Germany-A Systematic Review and Meta-Analysis.

Objectives: Higher education students in Germany are vulnerable to depressive symptoms. Despite ample evidence, no comprehensive review has recently been conducted. Thus, our systematic review and meta-analysis aims at describing the extent to which students are affected by depressive symptoms. Methods: We searched three databases for articles reporting the prevalence rates of depressiveness among students in Germany published between 2002 and 2023. Pooled prevalence rates were calculated using random effects models, both for the overall sample and for subgroups categorized by gender, study setting, assessment instrument, and whether the study was conducted before or during the COVID-19 pandemic. Results: The search yielded 992 records. After screening, 60 articles remained for data extraction. About one out of five students (21.1%) exhibits depressive symptoms. Pooled prevalence rates differ between subgroups, with higher rates during the COVID-19 pandemic than before (30.6% versus 18.0%) and with females being more affected than their male counterparts (29.0% versus 23.1%). Conclusion: This review underlines the urgency with which the mental health of students should be addressed at the (higher educational) policy level.Clinical Trial Registration: PROPSPERO, Identifier CRD42022384066.

Corrigendum: Adolescents' perceptions and user experiences with a virtual reality-based alcohol prevention tool in Germany: A focus group study.

[This corrects the article DOI: 10.3389/fpubh.2023.1054015.].